• End-of-Life Care

    • Respect patients in their final days

      The patient-physician relationship is unique in modern American life. Patients place their lives in their physicians’ hands. Not only must they trust in their doctors’ knowledge, experience, and skill, but they also must trust that their physician is acting in their best interest — neither motivated nor distracted by competing interests. In return, the physician is responsible for recommending and applying the most appropriate, science-based treatments for the patient’s individual circumstances and medical conditions. All of these pressures are magnified during the often-emotional final days and weeks of a person’s life.
  • End-of-Life Stories

    • End-of-Life Care: The Long Conversation

      "When we can have these conversations, it turns out that our clinical practice becomes a lot more authentic and satisfying because you actually can achieve valuable clinical goals even when you can't cure someone." 

      California palliative care specialist, author, and consultant Ira Byock, MD, calls the issues surrounding end-of-life care "a public health crisis." But he says many of the same solutions to improving the health care system overall — shared decisionmaking, advancements in medical education, better payment and delivery structures — apply equally to this area of medical care.

    • Difficult Choices: TMA Seeks Balanced End-of-Life Debate
      Different circumstances bring different levels of complexity to end-of-life care decisions, but one thing stays the same, Bellaire emergency physician Arlo Weltge, MD, says. "As physicians, our job is to act in the best interest of the patient, but with the ethical responsibility of not doing any intentional harm." That responsibility does not end just because a patient is nearing his or her final days. "We need a law that is nuanced enough to recognize that there are very different contexts in which these decisions are made," he said.

      As end-of-life issues heat up once again in Capitol debates, protecting physicians' ability to carry out that duty under the 1999 Texas Advance Directives Act (TADA) is a key feature of legislation TMA developed in collaboration with the Texas Hospital Association (THA), the Texas Catholic Conference, the Texas Alliance for Life, and other faith-based groups.
    • TMA Takes on Budget, Medicaid, Scope, End of Life
      The 2013 Texas Legislature kicked off Jan. 8 with a rosier budget picture than last session, which could be good news for TMA's goals of restoring many of the harsh cuts enacted in 2011. Senate Bill 303 could be another big step forward in helping to resolve the end-of-life debates that are a regular session item of late. The legislation protects doctors' rights to do what they believe is ethically and medically best for patients in their last days, while updating the Texas Advance Directives Act to give patients and their families more time and help during such discussions. State Sen. Deuell, MD, worked on the bill with TMA, the Texas Hospital Association, the Texas Alliance for Life, and other health care, religious, and right-to-life groups.
  • Forms, Laws, and Resources

    • DSHS Do Not Resuscitate Forms
      The Texas Department of State Health Services maintains a page with forms for use in the Out-of-Hospital Do-Not-Resuscitate program. The program allows people to decide that they do not want to be resuscitated.
    • Advance Directives
      Although advance directives have proven benefits for patients and families, few patients have them.
    • Medical Power of Attorney
      Durable Power of Attorney or Medical Power of Attorney is a document, signed by a competent adult, designating a person that the principal trusts to make health care decisions on the principal's behalf should the principal be unable to make such decisions.
    • Death Act: Directive to Physicians
      The Texas Health and Safety Code authorizes the use of a written Directive to Physicians in accordance with these guidelines.
  • TMA Advocacy and Communications